The federal Centers for Disease Control and Prevention (CDC) has announced a major update to the childhood vaccine schedule, reducing the number of vaccines recommended for children and shifting several shots to optional or guidance-based on risk factors.
The changes, which have faced controversy, took effect immediately and represent the most significant revision to the schedule in decades. Health officials from the Trump administration say the update is intended to address declining trust in public health following the COVID-19 pandemic.
Under the revised schedule, the CDC now recommends routine vaccination for 11 diseases, down from 18 previously. The updated guidance more closely mirrors the childhood vaccine schedule used in Denmark, according to media reports, including NBC News.
However, the CDC said all vaccines previously recommended remain available and covered by insurance. And parents who want their kids to continue receiving the full slate of vaccines can still do so.
The CDC will continue to recommend that all children receive vaccines protecting against measles, mumps, rubella, polio, whooping cough, tetanus, diphtheria, Haemophilus influenzae type B, pneumococcal disease, HPV and chickenpox.
These vaccines remain part of the core childhood immunization schedule and are expected to continue to be required for school and child care attendance in many states. States come up with their own school vaccine requirements, though they often rely on CDC guidance.
Several vaccines that were previously recommended for all children are now advised only for high-risk groups or through shared clinical decision-making between parents and health care providers.
Vaccines moved to high-risk recommendations include RSV, hepatitis A, hepatitis B, dengue and certain types of bacterial meningitis.
Vaccines now recommended based on shared clinical decision-making include rotavirus, influenza, hepatitis A, hepatitis B and bacterial meningitis. COVID-19 vaccines were moved to shared decision-making last year.
Shared clinical decision-making means parents are encouraged to discuss the benefits and risks with a medical provider rather than follow a universal recommendation.
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One of the most controversial updates involves the hepatitis B vaccine for newborns. The CDC is no longer recommending that all infants receive a hepatitis B vaccine dose within 24 hours of birth.
Instead, mothers who test negative for hepatitis B are advised to discuss the timing of the first dose with a health care provider. In those cases, the dose may be delayed until at least two months of age.
For mothers who test positive for hepatitis B, the recommendation to vaccinate newborns shortly after birth remains unchanged.
Acting CDC Director Jim O’Neill approved the updated recommendation from the agency’s Advisory Committee on Immunization Practices.
“This recommendation reflects ACIP’s rigorous review of the available evidence,” O’Neill said in a statement reported by The Hill. “We are restoring the balance of informed consent to parents whose newborns face little risk of contracting hepatitis B.”
The CDC did not adopt a separate proposal that would have encouraged blood testing in infants to determine whether additional hepatitis B doses are needed.
Health officials say the updated schedule does not remove access to vaccines or eliminate insurance coverage. Vaccines recommended as of the end of 2025 remain covered under Affordable Care Act plans, Medicaid, the Children’s Health Insurance Program and the Vaccines for Children program.
The childhood vaccine schedule is not a mandate, but it guides insurance coverage and informs state vaccine requirements for school attendance.
The CDC typically updates the schedule annually based on scientific evidence. This year’s revision marks a departure from the usual process and has drawn concern from some medical groups, though federal officials say no vaccines were removed due to safety issues.
For parents, the CDC advises speaking with a pediatrician or health care provider to understand which vaccines are recommended for their child based on age, health status and risk factors.
Health experts continue to stress that vaccination remains one of the most effective tools for preventing serious childhood diseases.
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